Objective: The study aims to evaluate the effect of increasing surgical expertise on outcomes, complications, and inclusion of larger adrenal tumors in laparoscopic adrenalectomy (LA) and address the limitations of traditional size restrictions. Methodology: A retrospective analysis of 100 lateral transperitoneal LAs was conducted from February 2010 to December 2021, including patient demographics, tumor characteristics, surgical outcomes, and complications. pn criteria were as follows: tumors >15 cm, primary malignancies, recurrent tumors, and extensive prior abdominal surgeries. We used multiple linear regressions to examine associations between clinical variables, surgical outcomes, and complications. Results: Lesions were located on the left (54%) or right (44%) sides, with 2% bilateral. Non-secreting adenomas (36%) were most common, followed by pheochromocytomas (33%) and Cushing’s syndrome (12%). Surgery times ranged from 15 to 180 minutes, with minimal blood loss. Complications included bleeding (1%), respiratory issues (2%), hypotension (3%), incisional hernias (5%), and port site infections (4%). A comparison between the first and last 5-year periods showed a significant decrease in operative time and intraoperative complications, indicating improved surgical proficiency over time. Conclusions: When performed by experienced surgeons, LA is safe and effective, even for larger tumors. Our findings support evidence that larger adrenal lesions can be approached laparoscopically by experienced surgeons; however, prospective studies are needed to define safe limits.
Muayad A. Fadhel (Thu,) studied this question.